Inhaled Corticosteroid (ICS) Pregnancy: No experience of use in human pregnancy or lactation; should not be used in pregnancy or lactation unless the expected benefits to the mother are thought to outweigh potential risks to the fetus or neonate. Evidence of safety in human pregnancy is inadequate; corticosteroids given to pregnant animals can cause fetal abnormalities including cleft palate and intra-uterine growth retardation, though these occur after relatively high systemic exposure and inhaled delivery avoids such exposure. It is reasonable to assume beclometasone dipropionate is secreted in milk, but at inhaled dosages there is low potential for significant levels in breast milk.

Beclometasone Dipropionate Inhaler

Brand names: QVAR (fine-particle), Clenil Modulite, Becotide

This is beclometasone dipropionate delivered by inhaler as regular preventer therapy for asthma, taken to reduce airway inflammation and the frequency of asthma symptoms and exacerbations.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 200 micrograms twice daily (usual starting dose); in severe cases may be increased to 600 to 800 micrograms daily

Route: Inhalation (Clenil Modulite pressurised metered-dose inhaler) — inhalation use only — source product: Clenil Modulite 100 micrograms inhaler (with Dose Indicator)

Frequency: Twice daily; the total daily dosage should be administered as two to four divided doses

eMC SPC §4.2 (Clenil Modulite), 'Adults (including the elderly)': 'The usual starting dose is 200 micrograms twice daily. In severe cases this may be increased to 600 to 800 micrograms daily. This may then be reduced when the patient's asthma has stabilised. The total daily dosage should be administered as two to four divided doses.' The starting dose should be adjusted to the severity of the disease, then adjusted until control is achieved and titrated to the lowest dose at which effective control of asthma is maintained. Spacer: the Volumatic spacer device MUST always be used in adults and adolescents 16 years and older taking total daily doses of 1000 micrograms or greater; it may also be used by any patient who has difficulty synchronising actuation with inspiration. Paediatric (from the same §4.2, not weight-based so not recorded as a structured paediatric dose): 'Children: The usual starting dose is 100 micrograms twice daily. Depending on the severity of asthma, the daily dose may be increased up to 400 micrograms administered in two to four divided doses.' Clenil Modulite must always be used with the Volumatic spacer device when administered to children and adolescents 15 years of age and under, whatever dose has been prescribed; a Volumatic with a face mask may help in children under 5 years. Advise patients to rinse the mouth or gargle with water, or brush the teeth, immediately after use. §4.4: does not relieve acute asthma symptoms — a short-acting inhaled bronchodilator is required and patients should have relief medication available; treatment should not be stopped abruptly. No absolute maximum dose is stated in §4.2. eMC §4.5 interactions was not retrieved in this bundle.

Dose adjustments

Renal

No dosage adjustment is needed in patients with hepatic or renal impairment

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Oral candidiasis of the mouth and throat (very common; incidence rises with doses greater than 400 micrograms beclometasone dipropionate per day)
Hoarseness and throat irritation (common)
Hypersensitivity reactions — rash, urticaria, pruritus, erythema (uncommon); oedema of the eyes, face, lips and throat (very rare)
Systemic corticosteroid effects — adrenal suppression, growth retardation in children and adolescents, decreased bone density, cataract, glaucoma (very rare)
Psychomotor hyperactivity, sleep disorders, anxiety, depression, aggression, behavioural disorders, predominantly in children (frequency unknown)
Paradoxical bronchospasm, wheezing, dyspnoea, cough (very rare) — treat immediately with a fast-acting inhaled bronchodilator and discontinue

Clinical monograph

How it works

The inhaled corticosteroid is deposited in the airways where it activates glucocorticoid receptors, suppressing local inflammation and reducing bronchial hyper-responsiveness.

Prescribing in practice

Most important: it is a preventer that must be used regularly and does not relieve acute breathlessness, so an inhaled short-acting reliever should always be available.
Check and re-check inhaler technique, and consider a spacer with a metered-dose inhaler to improve lung deposition and reduce oropharyngeal deposition.
Prescribe by brand because extra-fine and standard inhaled beclometasone products differ in delivered dose.

Monitoring

Monitor symptom control, reliever use, inhaler technique, oral candidiasis, and childhood growth on long-term use.

Counselling the patient

Rinse the mouth after inhaling to reduce oral thrush and a hoarse voice.
Take it every day as prescribed, not just when symptoms occur.

Evidence & guidelines

Regular inhaled corticosteroid use is supported by NICE and GINA as the foundation of maintenance asthma therapy.

Reference: GINA 2024; BTS/SIGN Asthma Guidelines 2019; NICE NG80; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Budesonide (Inhaled) · Inhaled Corticosteroid (ICS)

Pathways